138: The Executive Session: What it takes to be a successful practice owner?

Foreign. Welcome everybody, to another episode of the Dental Boardroom podcast. I'm excited because we are launching today a sub series within the Dental Boardroom podcast that is going to cover topics that are outside of my space of specialty. And it's going to get into practice management and it's going to get into dental marketing. And this series is going to have two co hosts with me that I know well, and I've seen them do such incredible things for dentists and many of our clients. And so let me welcome who is going to be on the panel of this new series that we're launching. And it's going to be called the Executive Session. And the concept there of the Dental Boardroom is some of the executives come in over different areas of the business. In this case, we have the executive over finance and that's going to be me. We have the executive over sales and marketing, and that's going to be Michael, who I'm going to introduce in a moment. And then practice management or operations is going to be Megan. So we're going to introduce both of you. And the unique nature of this podcast series is that it's going to be interdisciplinary, that we're all going to cover the same topic from our lens in the specialty service, the specialty skills that we provide to dental practice owners. And I have found that panel discussions tend to be sometimes some of the most educating and insightful sessions when I go to conferences. And I'm hoping to provide that same level of excitement and education to our listeners. So let's jump into a little biography here of each of us. All of my listeners know me, Wes Reed, owner of Practice CFO and a company called Practice Orbit, which is a tech company for buying and selling dental practices. And we do CPA and business financial and personal financial planning services integrated for the dental practice owner. And we've been around since about 2012 and are in San Diego, but work with clients nationwide. Okay, let's now go to Megan Shelton. Megan. I'm going to do a little intro myself, if you don't mind. Megan. I know Megan because Megan used to be a client of Practice CFO and in some ways still is. However, she is no longer practicing dentist, which she was. And she ran one of our most successful practices here at Practice cfo and we work with a lot of dentists and she did it remarkably well. And so she has now pivoted into practice management consulting and is doing really incredible things for her clients, some of whom are our clients as well. And so I thought what better of an Expert and than to have Megan come and join this podcast as one of our hosts. So, Megan, tell us a little bit about you.

Wes, thank you for that gracious intro. So I have been working with dentists who are often clinically brilliant, and the practice is still feeling chaotic and exhausting. Honestly, if we look at practices, they're being run on sticky notes, memory, and usually an empty ink cartridge with no backup in the cabinet and like a grain of hope sprinkled in. And so operations, leadership, wellness, culture, cash flow, where that collides is where I intervene. And so I founded Shelton Solutions after. After selling my practice and having an awesome run at it for over a decade, I decided that I really wanted to support dentists in having the same confidence and freedom, not just in their practice, but in their whole life. And so that's what I do. And I'm thrilled to be here today with both of you gentlemen. I'm, you know, virtually in San Diego, which has my heart and physically sitting here in Seattle, both two places that were pivotal in my professional career. So it's really fun to have this opportunity collide.

Well, excited to have you as a regular host here with me on this podcast, Megan. All right, Michael, let's pivot over to you. Tell us about yourself.

Yeah. So Wondrous Agency is a full service marketing agency for Dennis. It's been around for close to 13 years now. It's a little scary saying that I just turned 40 this year, so I feel like everything's telling me I'm just getting older. But my wife Laura and I co founded Wondrous Agency in our home. So we literally sat at a couch and sort of recognized this problem that so many dentists had. We had one of our friends come to us that was a dentist, and he said, hey, I've got this problem. You know, I've got all these companies and none of them talk to each other. I have no idea what's working. And from there to today, Wondrous now is a marketing agency that serves dentists all across the country, work with clients close to 1300 dentists around the country. And what we do for them is we make sure that we can help new patients find them the right kind of new patients. And so, you know, there's a lot of marketing agencies out there. I'm going to focus on the things that make us different.

Are you looking to buy or sell a dental practice? If you're a seller, how do you find a strong list of potential buyers? There's no MLS or Zillow for Dental Practice Sales in such a fragmented market, many dentists on the their practice feel discouraged. That's why I built practiceOrbit.com practice orbit is modernizing how dental practices are bought and sold. It's a platform technology. Y' all know them Zillow, Airbnb, Uber, and OpenTable, just to name a few. These technologies do two things. First, they help match buyers and sellers by centralizing the marketplace. Second, once the match between buyer and seller is made, these technologies help them navigate the sale Sale to a Successful close. Here are a few of the features inside a Practice Orbit users can determine a reasonable sale price for practice in just minutes. All they need is the most recent business tax return. Practice owners can use the directory to find important service providers like practice brokers, attorneys, accountants and bankers. Practice owners and their brokers can invite those service providers into the platform so all parties are quite coordinating the sale together. Practice owners will have a beautiful digital listing of their practice like a home on Redfin. And importantly, the listing will be anonymous and personal information like your address, name and pictures are only released after an NDA is signed and approved by you or your broker. Practice buyers can create saved searches to be auto notified when new listings come on the platform that fit their desired specialty and location. And hey, dental practice brokers, you can list all your practices on the site for free. By doing so, you'll get access to Practice Orbit's large pool of buyers, all of whom have created profiles and saved searches to be auto notified when new listings come for sale. You can use the platform to introduce your listings to a targeted set of buyers. Additionally, and optionally, you can use the platform tools such as a built in NDA, a customer customizable loi, and a workflow tool to navigate the sale from LOI to closing. In fact, you can manage all your listings on the system, from listing the practice to NDA to loi, and finally to closing the deal. Create your free account today at www.practiceorbit.com.

So of course we do the storytelling side. We build websites, we build brands, we do photo video, and then we get the story out there through SEO, Google Ads, social media. But that's not what makes us special. What we really do well is we help differentiate clients. We help them find something that they can really identify as different in their market. And that's so critical to marketing. If you don't do that, then everything else falls apart. And I think one of the things we'll talk a lot about in today and in future episodes is how do we actually Track results. So many marketing agencies talk about numbers, talk about data. I'm willing to bet many dentists have had this experience where you get a report and it's got keywords up and traffic down. And I can't keep it all straight. You know, what I care about is new patients. And so for me, we focus on integrating with practice management software. We focus on actually getting to the numbers you care about. How many new patients did we generate? How much did it cost? What's the roi? So that is such a critical part of marketing. It's something Wondrous has spearheaded in the industry. And, and the last thing that I want to talk about for Wondrous, which is kind of old school, old fashioned, is service. We're a brick and mortar business. We have 65, close to 70 people in San Diego that come to work every day. I know we're just down the street from us. So you know this and just not being a band of freelancers strewn throughout the world makes such a difference. It means we can really serve our clients hard and make sure that, you know, when there's a problem, we can pick up the phone and. And when marketing thrives, it's because there's proactive work being done by people in an office here, not reactive work, you having to remind people what to do. So, yeah, excited to talk about all things marketing and all things dentistry. Thanks for having me.

Excited to have you. One of the reasons why I wanted Michael on the podcast was because I think Michael has a much more of a tech focus than most, if not all, marketing, dental marketing companies. I know that I'm aware of, at least in that you've invested a lot of money in creating integrations with the practice management softwares. You have a developer in house and so you're very tech enabled in your marketing services. And I think that dentists today, if they don't have more of a tech enabled process to send out their marketing content, to retrieve it back, to track the data and to do it efficiently. I think you're going to be fighting an uphill battle without that. So I'm really excited to hear your contributions around the tech side and particularly around how AI is starting to play a role in the marketing space for, for dentistry. And so if we zoom out a little bit, we look at this panel, me, Megan and Michael think of like a funnel of the way a doctor earns income. And as much as I know doctors enjoy being a dentist and they find a lot of value and purpose in it at the end of the day, they need to have, they need to make money. And that money needs to support a life that gives them fulfillment and joy. And how do they translate these patience and marketing spend and operational spend and spend on their team, and how do they translate all that into ultimately what I always call their personal balance sheet. Their personal balance sheet is everything they own, less everything they owe. And that the difference between those two is net worth. And net worth isn't self worth, but that net worth number, that balance sheet is what drives their ability to say, I have flexibility around money in my life and resources and I'm getting to a point where I can live off that instead of my hands and my skill set. It doesn't mean you'll stop doing dentistry, but it just gives you incredible flexibility in your life or even while you're as a practicing dentist and maybe not financially independent, yet you're able to have adequate resources to live a good life as well. And so the marketing is helping find these patients to come in and bring them in at the top of the pipeline operations is once that call is made or once, you know, that first visit walks in the door of the patient, how do you make that an incredible experience for them and how do you properly monetize it? And I don't want to make it sound that patients are walking money machines. They're not. But you have to figure out how to, how to have proper margins, otherwise you're not going to run a business for long. So you have to think about it from a financial perspective from that standpoint. And so that's what Megan and her skill set is, is how do you take that patient through the experience once Michael has helped find them into a really positive outcome clinically and financially for both you and the patient. And then for me is once that dollar hits the bank account, whether that's coming from insurance companies or directly from the patient, how do you make sure that a plink goes throughout the P and L in an efficient way, ultimately pays your overhead, debt and taxes? And we maximize what's left. We maximize what's left. So you can pay for yourself today and you can pay for yourself in the future. And that's where I come in to play as the finance guy on the team. So I think this is going to be a really good pairing, the three of us. I'm excited about it. Let's jump into today's topic. And our kickoff topic is really just high level questions about what we're seeing in the industry right now as it relates to our specific expertise. And so I've got a handful of questions here I'm going to kick off. The first one is how has the definition of a successful dental practice, how has that definition changed to today's dental industry compared to, let's say, 10 years ago? What's different that makes a dentist thrive or be successful today? That maybe is different than 10 years ago? Why don't we kick this off with Michael?

Yeah, it's so interesting. I think Even over the 13 years we've been doing this, you can really see the legacy of what I would call traditional dentistry. You graduate, you go do bread and butter dentistry until you retire, and then maybe you have an associate that you sell your practice to and you hand it off. And that was a full career. You work through back pain, you work through shoulder, you take that until you retire. And I think what I've seen even in my career is the emergence of the entrepreneur dentist, someone that comes in with a business mindset, not just a clinician. Right. Sometimes this is something that we struggle to talk about in dentistry. Does it have to all be clinical? No, clearly we have this entrepreneur dentist. And so I think what I'm seeing is that we have dentists that are looking at lifestyle. You know, this could be, how do you know? How do I want to focus my time? Am I going to be a dentist forever? No, I'm actually not. I'm going to progress into real estate. I'm going to do other things. We have dentists that focus on what type of dentistry they want to do more. That was less of an option 20, 30 years ago is all bread and butter supported by specialty. And now it's, I want to get out of that and focus on implant aligner, these specialized areas. And so I think the combination of that has meant that we're both evaluating financial success with life success. Right. Is this supporting my lifestyle? Am I happy? And so I think that there's a lot more to consider. I think it's a great trend in dentistry, but it's certainly not the straightforward path. Graduate dental school, work till you're 55 or 60, sell to your associate. I think those, those days are increasingly gone and people are looking for more.

Agreed. Megan, you want to add to that from the practice management lens?

Absolutely. Wes. Michael, you nailed a lot of it. You know, lifestyle is such a big buzzword in our society today. And the, the newer generations are taking ownership of that lifestyle and really instilling, instead of working for life, we're finding ways to integrate. You know, there's, there's this Common theme of balance. And I really don't see balance as being the best word to use for that. More of like integration and finding ways to build our schedule to support what we need to do at home with our kids or our spouses or our fill our other buckets in our relationships and physical health. Right. Wellness is also another buzzword. And so you'll see wellness creeping into how we take care of our teams, how we take care of ourselves. And then even it's going to transpire and we'll touch on that more, but how it's folding into how we take care of our patients.

And I'll say I don't have a single quote, successful dentist. And I would define that as a dentist who has a good top line but also a good bottom line. And top line is collections. In my world we just call it revenue, but it's collections. But then bottom line, which is your, what we call your operating income, that's your cash flow after paying for labor, lab supplies, facility marketing and admin, but before paying you debt and taxes. And that operating income is kind of the punchline of the profit and loss statement. And what I find is my doctors who have both a strong top line and a bottom line, they eagerly review their financial statements each month and they eagerly engage their financial consultant or CPA here at practice cfo, we call them the CFO advisor. And because they know that what's measured, as we all know that the quote, what's measured gets improved. What isn't measured tends to atrophy or, or flatline. And so the doctors that I find that are successful today financially know that I'll say sometimes top line can be vanity, bottom line is sanity. I do have some doctors who work insane amounts. They may have two or three locations and they have pretty good top lines, but their bottom line is the same as a $800,000 practice, you know, with the 45%, 40% profit margin, which isn't bad. But I'd rather have an eight hundred thousand dollar practice with four of five employees taking home three hundred thousand than a two million dollar set of two practices taking home the same amount. Because one's going to give me life and the other one isn't. And so top line, vanity, bottom line, sanity. That said, in dentistry, because so much of the costs are fixed, meaning regardless of how many patients come in the door, you're going to pay the same amount for rent, your team pretty much is going to get paid the same amount, you're going to pay a lot of your, your fixed Overhead, it's going to be the same amount. Very few costs are actually variable in a dental practice. Therefore, you need a pretty good top line. So when I make that statement, top line is vanity, bottom line is sanity. It doesn't mean you don't need a good top line. You do. A lot of the problems are revenue problems, not just expense problems, but. But they really manage it there. I love that term, entrepreneurial mindset, Michael, because an entrepreneurial mindset is somebody who knows that it's not just about delivering the product, it's about creating a platform around the delivery of that product or service. And that's all the business side of it. And they have to be good at that. We've all learned that. In my case, I feel like I had to learn that the hard way, but we've had to learn that. So that's what I find. They're just really engaged with their numbers. I would define. That is one of the key characteristics needed to be successful today. I think if you go back far enough, you literally just post your sign out the door and you're probably good. Those days are gone.

Hang a shingle.

Those days are gone. All right.

Yeah, they're long.

Let's hop into the next question. What do successful practice owners focus on when running marketing campaigns? So this one's going to be in your area, Michael, a little bit more. What are these successful owners focus on when running these marketing campaigns? To make sure that they're actually driving growth and not just spending money. Because I have seen a lot of marketing dollars just tossed in the wind, and a lot of times they don't even know. They don't even know if it was tossed in the wind or actually produced results. So what are your thoughts on that question?

Yeah, I think this is probably one of the chronic areas of just something that's not working in dentistry, where we see it all the time. When we talk to someone who's frustrated with their marketing and we'll ask, we'll say, well, tell us how's it going? What's the performance? And they don't know. And that's kind of the catalyst for them to look somewhere else. I don't know. It doesn't feel like it's working. And if you think about it at the end of the day, as a practice, the best way for you to know your marketing's not working is when the phone's not ringing. And when you look at your P and L at the end of the day and it's not growing. Right. So that never Lies. You could talk about ranking numbers all day long. You can talk about website traffic and social media likes if you're not getting more new patients and you're collections are not growing, you know. And so we have chased this problem for years. I still remember early on being on calls with doctors and talking about rankings and talking about traffic, and then at the end of it, them saying, well, I don't think it's working because. And so from that point to now, what we've worked very hard to do is to integrate with practice management software. Now, the first attempt at this we made is we used to email office managers once a month and say, can you pretty please go into this spreadsheet and update, you know, the new patients here? And, you know, it's, it's funny. You're laughing, right? We know about 10% or less of them did it. So we had blinders. We didn't know, which means we had to be reactive, not proactive. We had to wait for someone to tell us it wasn't working. Well, today, I think best in class marketing is focused on integrated data. That means we take marketing data, how many phone calls do we generate, how many leads filled out a form, and then we look at that list of phone numbers and names and we compare it with the ledger that exists in the practice management software. How many of these leads now appear in this practice management software as new patients? So without ever having to talk to the front desk or the doctor, we can say, hey, good news. Last month we generated 100 leads and 25 new patients came in, and you collected $30,522. Like, things are good. I would argue even more important, though, is when things are not good. Because here's how marketing works today. How marketing works today is the marketing agency says, we're driving leads, this is going great. And then it's up to you to figure out, is that true? And most of the time, months go by until you finally say something's wrong. So it's so important that we can proactively see when things are not going well so we can make the changes necessary. So the two pieces of advice I have here, One, make sure you're working with a marketing agency that integrates with your practice management software. And number two, Wes, I loved you said your clients are eager to talk to you every month. Right. Be eager to talk to your marketing agency on a regular basis, quarterly, if that works for you, or monthly, and know which numbers you're going to hold them accountable for.

Yeah, I think Dennis should at the end of every month or maybe even a couple times during the month. But they should sit down. And this is what I find successful dentists do. I I've got a a client here in La Jolla who He has a $5 million practice. He individually only does 400, 000 of collection and he's 100% owner. But he spends probably five times more the amount of time on understanding his data and helping or managing a lot of the operations of his practice. Now he's a bit of an extreme and I'm not saying everyone should become three part business owner, one part dentist, but instead of being four part dentist, zero part in owner, I think they need to be at least one to two part business owner. And if you want to run, you know, a 2, 3, $4 million practice, that ratio of business owner to dent to dentist needs to increase over time to do that effectively. Because things start to shake as you get bigger. More employees, more need for process, more need for better hr, more, more need for systems, more need for marketing programs. All of that increases in relevance as the practice grows. Do you ever feel lost in your practice finances? And how about your personal finances? Ever wonder where your hard earned money goes and why you're not seeing the financial progress you've worked so hard for? If so, listen up. As a dental CPA and financial planner, I've created our company Designing Practice CFO just for you. With almost two decades of experience, Practice CFO integrates great CPA services like accounting and tax with customized financial planning, both business and personal. Think of it this way. Our dental focused CPA services give us the X rays we need to clinically plan your global finances and be effective financial planners. It's a highly customized approach we call the CFO model. Historically, having a CFO or Chief Financial officer was an advantage of large corporations only. But today, Practice CFO gives that same advantage to private dental practice owners. As a client of Practice cfo, you'll be assigned one of our dedicated CFO advisors. You'll receive insightful financial reports each month, have regular financial review meetings, reduce taxes, grow your wealth, and feel more in charge of your numbers. Because we believe that in the competitive landscape of dental practice ownership today, you have to be an effective business owner, not just a capable clinician. Reach out to learn more at www.practicecfo.com. So let's pivot this question over to you, Megan. When it comes to the marketing and the marketing campaigns to make sure they're actually driving growth and not just spending money, we're where does operational management come into play in this marketing flow?

Well, Wes, like you said, it's definitely making the time to analyze is this working? And then also, what is the message and who is the patient I want to attract? So, you know, is it working? Is it working in the sense of we're gaining and retaining patients? Are we taking time to listen to the incoming calls and are they the right patients for our practice? So have we conveyed who we are, what our vision is to people like Michael, so that they can make sure they're supporting us in a way that fills not just our financial needs, our sanity at the end of the day, but also that it's the type of dentistry we want to do, and we're getting the type of patients that we want to work with. And. And that's where I see a lot of misses. Um, and. And then I also see the gap with owner docs. They'll say, you know, I don't think my marketing's working based on what they're like. I don't know. I just don't know. I don't think it works. Well, you know, are you looking at the reports that people like Michael are providing you? Are you analyzing and listening to your calls? Are you taking time to coach your team on that? And then are we also tracking our attrition? You know, so if we're not growing yet, we're getting new patients, does that mean we have a leak in our ship? And. And what is the cause of that?

I remember I had a young, really ambitious marketing consultant, and my client found him through, like, a local business owner group. And he would come into my office, and the three of us would sit down, and he would open up this spreadsheet. He would show all these numbers. He's like, I'm doing my job. Look at all these new calls you're getting, all this new inflow of communication coming in. And yet, six months into it, we weren't really seeing much change on the P and L, which is the end of kind of the pipeline, and that's my view of it. And it was just this really challenging problem to understand why. And I think it's because you 2. Your two areas need to function hand in hand. Michael can feed that pipeline, but somebody's got to get that pipeline to convert. So there's finding or prospecting or opportunity creating these opportunities, and then there's converting them to a patient in the chair who says yes to a case acceptance treatment plan, and then there's collecting the money. So there's this whole Pipeline. And I find that those doctors who create visibility through the whole pipeline, not just how many calls come in, not not just how many appointments are met, but also case acceptance and ultimately collecting, those are the ones who have that visit. Visibility can make the right decisions to improve it as needed. So I would just want to emphasize that it is an investment, not an expense, in my opinion, to find good marketing and good practice management consultants. And I think one of the things that dentists need to develop as a mental talent is to understand what is sort of a commodity cost that is purely about the cost and what is an investment, that the results are highly dependent upon the individual resource talent that is being paid for. And I think your two areas definitely is an area of investment as long as the doctors are tracking the data and the results, and the sooner you can find out whether it's working or not, the better. And so when somebody's with another marketing firm and if they're tracking the data properly and they realize it's not creating opportunities, they should terminate that person and go hire Michael. That's my bottom line there. Hire Michael and. And then hire Shelton, Sorry, Megan. Megan Shelton, Shelton Solutions. In order to convert those leads into patients in the chair saying, yes, and then I will help you manage your taxes and cash flow. I love the flow. Okay, Any other comments on that question before we move on?

No, I think Wes, like you nailed it, really, for me, seeing I have a client who last month, actually the start of this month, she sent me a screenshot of her case acceptance tracker. And one thing we do that's really unique is we pull out the data from new patients. So we're not just seeing the revenue generated from the new patients, which is what Michael's seen, but we're seeing the dentistry presented and dentistry accepted. And what I'm looking to see is did we get the right patient and did we meet them at a trust level that's comfortable with them? And for this client, we had 85% extension acceptance on her new patients, which tells me her marketing and her intake is in alignment right now. And that's going to be something that's going to drive her bottom line, also going to reaffirm, you know, that her marketing continues. So it keeps all three of us working symbiotically to support her and get these patients healthy.

So I think that feeds nicely into this next question, which is what systems or disciplines must be in place for for a practice owner to grow profitably instead of just getting busier. Who wants to take that one?

Michael, you Want it? No, I'm teasing. Well, gosh, which system? That's hard to say. There's so many. But I do think when we're looking at growth, having clarity of what type of growth and where we want to go with that is important and clear expectations for our team and ourselves. You know, as I see dentistry expanding the practices that don't operationalize on wellness and don't capitalize on value based care, they're going to struggle in the future. So building employee retention, you know, that's controversial right now everyone has a hiring shortage, but maybe it's a leadership shortage because the practices that are probably performing really well are not having hiring issues. So it could be we should start reframing and relenting to look at retention. You know, employee retention should be a system that we're working. Focusing on wellness should be a system how we present cases and communicate and then executive functions. How are we connecting with people like Michael, like Wes? Are we making the time to analyze that data and make forecasted decisions so that we can end our year prosperously?

Agreed.

I want to give an example of what we run into and where we love when we have clients that work with coaches like Megan. And here's a good example. We'll work with a practice that maybe is a scratch startup. At first. They say, just give us patience. Any patients are good. And then all of a sudden, year one and a half comes around and say, hey, I just took this implant course and I think I want to start doing more of that. Can we focus our marketing on two implants?

Right.

Cool.

Easy peasy. Came out of a phone call, came out of a course, no problemo. Right. Well, so many things to consider. First of all, one of the big issues I see from a system standpoint is you got to actually look at how are you going to position yourself in the market? Do you have, like, no one's coming to you to start out with because of your reputation, so maybe you have to compete on price or something. Right. So how do you stack up? Actually, I love asking our clients. How did you decide on that special offer? Well, that's what I, my friend does that. Okay, like. And so, but from there we go into. Have you talked to your front desk about this new initiative in your business? Do they know about this? And then have you built a system for when a patient comes in that is going to sit down with a needy knee? I love presentations. I think, hey, if you don't have slide decks that you can pull up on a screen and say, let Me walk you through a few educational points. And it systematize. All of these things lead to case acceptance, which is exactly what Megan's sharing. And so for me, I often see this spark of an easy decision. Oh, I want to focus on implants. Hang up the phone, slam the laptop shut. Does anyone know? And if you really think about it, that is multiple weekends of your time thinking about a system that will support a seismic shift in your business. And either you're going to do that on your own, or you're going to call someone like Megan, say, I know I'm missing things. What do I need to do here? And this is where oftentimes our campaigns stall out, where we say, we're getting it out there. There's people that want to do this, but the front desk is answering the phone and say, oh, you know, I've had people say, well, there's an endodontist down the street that does that. You're like, whoa, wait a second, what's happening here? You know, like, you didn't communicate.

So, Megan, I want to ask you a lot of. One of the biggest questions I get from doctors. And we've helped a lot of doctors buy a practice and step into ownership and get their financial structure in place with their accounting and their tax and all of that. And a lot of times they really need a Megan. They need a good coach in there to help them scale their practice. Why? Because they've never done this before, and they were never trained on this before. And unless they really went out of their way to learn this somehow or had some sort of leadership experience elsewhere, they're very raw at this. And so they could benefit by your services a lot. But they will often say, almost every time, am I ready to afford it? Can I afford that? Because that amount, whatever that is, for you to be really engaged, it requires a lot of your time. It requires your skill set and. And a deep commitment. And that's not going to come at, you know, $3,000. It's just not. And you in your area, I think in all three of our areas, people get what they pay for. And especially I think with good practice, management consulting. So what is your answer to that? If I'm a dentist, I say, megan, I really want to hire you. I just don't think I can afford you yet.

Afford me?

That's the question. That's the question I get. I don't think I can afford X, Y, or Z. I get it myself. I got an email yesterday. I don't think I can afford your CFO fee quite yet. I just bought my practice, and so I answer this myself, but how do you address that?

Well, for me, it's, can you afford to continue on the path you're on for the next few years? Is that sustainable for you? And can you make the impact alone without making changes or having someone to help you operationalize and systematize your practice? Do you have that time?

I think what that's driving at is.

I mean, you can't afford not to, right? Like, we both, we all know it. Our clients that work with high tier marketing firms, our clients that work with high tier labs, that work with high tier, you know, coaches or financial advisement firms, they're doing everything they do at that level. And they didn't get there on accident. They got there because they surrounded themselves with people who have a certain level of expectation and they're going to bring you to that level with them. And so I think if, if you're choosing to, it's just like your patient, you know, they're like, I want the cheapest option, you're gonna get the cheapest outcome. You know, it's the same.

That's my favorite part.

What are we talking about?

All of our dentists have the same thing said back to them all the time. Need a knee every day, right? And so, so they know the answer too. And it's, it's.

But that value system, maybe the answer is leaking into their patients. And so until I can evolve their mindset, they will never get unstuck from that. Because if they're doubting if they can afford me, well, no wonder their patients are doubting. If they're like, their patient is saying, like, I'm not sure I can afford Invisalign. I'm not sure I can afford an implant. Well, that's transpiring from this doctor sitting chairside because they have that same scarcity or, you know, relationship with money and abundance.

I think patient experiences are, generally speaking, very much under what they should be in a dental practice. And that's the same with, like, CPA firms and a lot of professional service firms. I think there's an underperformance or under delivery of value commonly. And I do think people should be very careful in who they're lining up as their roster of support people and consultants and their own team. But one of the things I found in my life, I pay quite a bit of money for a good coach. He's a business coach slash a little bit of a life coach. And I pay really good money to this but the thing about it is, I think business owners need to be so hungry to learn. I mean, have such an appetite, such a curiosity, such a willingness to spend not only their time, but yes, some money as an investment. Because if it works, if Megan comes in and helps you increase your case acceptance right away, a stronger patient experience all around, better system, that is an immediate return on investment. So let's say over an 18 month period you pay. And I have no idea what the fees are here, so I'm going to throw out a big number just to accentuate my point. You drop 100 grand for a practice management consultant over a 12 to 18 month period. Okay, that is 100 grand. I get it. It feels like a lot. But what if you increase your case acceptance by 10%? What does that translate into? Especially if that means a recurring patient that stays around a lot longer. In business we look at what's called the lifetime value of a client or the lifetime value of a patient. And I think dentists don't understand that if you get a good patient, the cost to acquire that patient and the cost to service that patient through really good practice management processes will have a return that over the life of that client makes the cost of you both so insignificant. When you understand the lifetime value of a patient. And that's why it's really hard for dentists who have been struggling to make ends meet for so long and they have this pent up consumerism I call it, to immediately go buy the nice cars and the nice house. And I say keep living like a dental student a little bit longer so that you can invest in people like Megan and Michael. And less is more. Less spending in your personal life allows you to have more resources to build your practice and this operating system. So I'm going to share my screen and just share one thing real quick that I this is my viewpoint on it and I'm happy to get critique or feedback on this Megan and Michael, but a lot of our listeners watch this on YouTube and so I'll occasionally show some visuals. But what you have on the screen for those that are just listening is a diagram. It's an infograph that shows the doctor at the top. And I call you the CEO and I need you to think of yourself as the CEO because you are a, you are a corporation shareholder, 100%. Most doctors are s corporations and you are a business owner and you are the CEO. It's literally in your corporate records for those of you who are corporations. And then I have, on the left, I have they Have a cfo. So think of a big business. They have a CFO and then on the right they have the chief operating officer, or of course we're calling this the practice management consultant. Most dental practices cannot afford to pay a full time CFO and a full time chief operating officer in the practice. So they typically fractionalize these things. Same thing with marketing. They don't have the resources in a $1.5 million practice to go pay $250,000 for a full time, $300,000 for a full time marketer. And so what I don't have on here that I need to add, Michael, is I need to add you. I need to add, I would think those are monthly, in my opinion, monthly meetings of at least reviewing the data and a 30 minute to an hour long conversation to review the data. But I have meeting with the cfo, that would be us every three or four months. And that's what we do with our clients. Meeting with the practice management consultant. Monthly or quarterly, or maybe in the beginning it's weekly, I don't know. But these periodic meetings with the strategic leadership team, then I think every dental office needs a really good operations person, a good front office person, somebody who can really act as a support to you. And in my business I have someone, her name is Janine and she makes my life infinitely easier because she deals with so much of the commotion at the front, so to say, metaphorically speaking. And, and then on the bottom, I have of course, your main team members, hygiene assistant, front office and associates with sort of daily huddles and periodic trainings. But there needs to be a really good roster and a really good pulse or cadence to how you meet with these people to absorb information and learning and then to your team to of course inspire them and to run a good, a good dental practice. So I would say when it comes to what systems, I really am a big believer in your team. And your cadence of meetings is one of the most important systems that you could have. I'm going to stop sharing that. All right. And the last question I'm going to ask is it's just this. For a dentist to have a really good personal life as they grow their practice, what should they be focusing on as a dental practice owner to help them have a balance in their life. So it's not just about the business all the time in their mind. Michael, you want to kick off a thought on that one?

Yeah, I think that's something that we all struggle with. And the first thing I would say is that there's chapters and seasons to this. Right. So I think one of the tough things is someone that's listening to this. Right. The answer I would give today or the answer someone else would give, give is different. And I like something that Megan said. Right. I think a lot of times people throw out this word balance. And I'm here to tell you, as an entrepreneur, balance is not right for every season. Right. If you come in and you listen to some podcasts of people that have spent 10 years building their business, they say, balance is what I'm focused on today. And it's your first month. I'm going to tell you right now, balance is not your thing. Like, you're going to go hard. But I think the biggest thing we don't do is we don't have meetings with ourselves. Right. We don't look and say, where do I want to go? It's going to change. But I need a vague understanding. Is my goal as a dentist to get to four days a week, three days a week? Is my goal to prioritize family? Is my goal to prioritize a different clinical pursuit or passion?

What.

What is it long term? Get that out there, write it down, and then check in with yourself. I think that's the biggest one. And then my wife and I found this in our journey. I would just say be open to seasons, be open to change. It's not something that just smoothly, you know, goes to one place. All of a sudden you're back to a place where you have passion and you want to make the business the focus. You're grinding, you're there. And then there's other seasons where you step back and say, I need to focus on something else. So I think just being open to the fluctuation and having clarity. Don't let the river take you. Which is often what happens if we're being real with ourselves. I don't even know how I got here. Be happy that you stepped foot in the river and you chose to go on that ride and that's where you want to be.

Megan, shed some light on your thoughts.

Yeah. A few things that come to mind. I would echo what Michael said, and then I would also add not being afraid to communicate or invest in the support and help you need. I think as entrepreneurs, we can sometimes be very passionate or controlling about a direction that we seek. See. And using the support, whether that's your teams, your significant other at home, I would say, you know, some of the best things I did was elevating the people that believed in me within My organization. Right. You go back to that organizational chart. The person who became my ops manager was someone who started as an assistant who could barely hold a suction. But she had the attitude, she had the. The dedication, she had the need. And she. I mean, she could probably teach some of the things I know about dentistry. She understands and can communicate and she cares, but I could tell her when I was in need. And then the other thing was making a good choice on your. On your spouse. I think that's a huge one. Who that person is standing beside you. And we don't practice. Probably give enough emphasis to that. And for me, that's been a huge ability to be able to go through the seasons and dedicate my time to my business. When I was. My practice, there were times I was. You know, people see this. Like, I was in my office till 1:00am Sometimes, you know, my phone's dead and my husband's checking my location, like, where are you? But I was just like, so in the flow. And so he knew that those were the times I needed to put in that. That labor of love. And so having communication, using your support, hiring help at home. And then, gosh, I think also for dentists, mental health support is a huge one if you need it. And having coaches and advisors on your team.

I love all those comments. And it is so true that there is a. There's a life cycle to being a business owner. And when I started practice cfo, I was making so little money, and I was working like 80 hours a week. My highest week, I clocked 109 hours. It was pretty insane. That was during tax season, back when I was doing the tax work myself. And eventually you'd start to take off these hats. You start to have a little bit more resources, a little bit more reputation, a little bit better branding. And one of the most important things I think all business owners can do is what we call capital allocation, which is, how do you allocate your surplus dollar to get the most incremental benefit out of that dollar? Is that in marketing? Is that a new op? Is that a new CAD cam? Is that into practice management consulting? What is the best use of that dollar? And. But it takes. It takes time to do that. I think getting this time alone, like you said, Michael, I call that a clarity break. And it's something I struggle to do. But every time I do it, I'm like, wes, I need to do that more often. Where I'll take a day to myself. I'll go to the local library by myself. I'll go get an Airbnb. I've done that once by myself. And just take a day away from it all, go analog, get rid of that tech and just start letting your thoughts go down on paper and organizing them. And you start to see your life, I think, with a lot more clarity in context. When you set everything aside to do that, the last thing I'll say is in terms of seasons, when you first buy that practice, or if you've never really built out a good system around operations and marketing and finance, I think you've got to do that. And I view it almost like developing a software in the beginning. There's a lot of time and even quite a bit of money that can go into coding that software. And you have to think about all the different sort of scenarios and whatnot. It just takes time. Once the software is done and released, then it becomes. It's just a simple maintenance of it. I call that maintenance mode. It's like you get the tire going, you have to really pump it. And then once it's going, every once in a while you just give it a nice spin and it keeps going. Or, or getting that rocket ship out of the atmosphere. So much energy at first, but once you're in the atmosphere, out of the atmosphere, it's just really little checks, little, little balancing going on. And so for everyone, I know it takes a lot of time, a lot of mental energy and even some money, but please build out that system to be a really good business owner as well as a clinician and define what you want out of life and what's enough and what will make you happy. All right, that's the end of the questions. I just want to showcase a little bit what we're going to be covering going forward on the finance side this year. Here are some of the things I'm excited to talk about. Financial KPIs that every practice owner should review monthly. When to reinvest in the practice versus take it out of the practice to sort of pay yourself red flags to watch out for in growing practices. I would say cost cutting versus strategic investments and cash flow forecasting and how to do these things and the value out of those things. So really excited about that. Megan, what are some of the topics you want to present here this year? On the practice management side, I'm looking.

Forward to discussing with you all systems that help predict growth so we can prevent chaos. KPIs to ensure that the practice is getting our patients healthy and leadership tools to help with employee retention.

All relevant for practice owners Michael.

Yeah. So, you know, I'm excited to actually get into some things that you can do. Right. Sometimes marketing feels theoretical and we'll talk about some of that, but I want to really boil it down to things that you can take away. And so there's a lot changing. Marketing always does. And so things that are top of mind for me that we'll talk about AI. And now this new thing that we're calling aio. So a lot of you might know SEO, right? Hey, I just learned about that. I'm doing that. Oh my gosh, there's something new. Yes, there is. We have to optimize for AI. A lot of you have an idea that we should get the word out there through ads, like Facebook ads, meta ads. What is holding those campaigns back? Everybody's probably tried it. A lot of people said, hey, it hasn't worked. What's the number one thing holding your, your meta ad campaigns back? The power of video. We all kind of know video is a thing, but it feels pretty inaccessible to a lot of us. What do we do if we actually want to use video in a way that's going to be meaningful in our practice? And then, you know, something that we talk about all the time. I am sick of insurance. I want to do this fee for service thing. How do I do it? What is a path in marketing without just discounting to get you to a sustainable fee for service practice?

Amen to that. I'll tell you what, when I started the practice, I practice cfo, I was just giving discounts all over the place because it was like any, I just need people in the chair, so to speak. And. But you get to a point, eventually you realize I actually need to define my strike zone. What is the patient, in my case, the client that fits my strike zone? Because if you scale and you scale when your margins are negative, guess what? You're just inflicting a lot of pain on yourself. And so that defining your just like defining your life goals, you got to define your practice goals and the type of patients. But I'm excited to talk about AI. It's also playing a role in my space of accounting and finance. And I'm working to be able to do more real time reporting where our clients can log in and have a dashboard and see their numbers partway through the month to where they are. They don't need to wait until a week or two after the month to see their historical data. I'm really pushing toward that here at practice cfo. And then, Megan, I suspect you're seeing AI softwares, they're popping up left and right.

Yeah. Helping with diagnosis, helping with patient coordination, all the things. And so finding ways to utilize that to allow us to have more connection with our patients. Because that's, you know, people are still longing for that human connection. So making sure we're delegating the right things. And then how are we using that time that we're buying back through that delegation?

Well, I'm excited to do this. We're going to do this episode, the executive session, twice a month, and we're going to try to be really consistent about that, in spite of us all being very busy. And this was our first session, so we're sort of breaking the ice, getting comfortable a little bit with each other. But I am just so honest, optimistic and excited about the content we're going to create for our listeners. And this multidisciplinary approach, I think is relevant because that's what it's like in business. That's real life, is you have to see how it all feeds into each other in this circular reference, the way it all relates to each other. So thank you, Megan and Michael, for being on the show. Until next time, have a great one.